In the United States, A disease that was largely controlled, typhoid fever, is rapidly emerging as a major public health risk worldwide.
Resistance to antibiotics in Salmonella enterica serovar Typhi (S Typhi)—the causative agent of this illness—continues to rise.
It is uncommon in developed countries, yet typhoid consistently causes challenges in developing regions, primarily South Asia.
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For the past thirty years, S Typhi has become increasingly resistant to antibiotics and has spread accordingly.
Genomic sequencing of 3,489 S Typhi strains gathered from Nepal, Bangladesh, Pakistan, and India between 2014 and 2019 revealed a significant increase in extensively drug-resistant (XDR) typhoid strains.
The findings suggest that S Typhi has become resistant not only to the leading antibiotics such as ampicillin, chloramphenicol, and trimethoprim/sulfamethoxazole, but also to fluoroquinolones and third-generation cephalosporins.
Due to unexpectedly rapid evolution, the new typhoid strains present in South Asia are pushing aside less resistant forms.
According to the infectious disease specialist Jason Andrews from Stanford University, “The speed at which highly-resistant strains of S Typhi have emerged and spread in recent years is a real cause for concern,” dailygalaxy.com reported.
Even though most documented XDR typhoid cases originate in South Asia, with Nepal, Bangladesh, Pakistan, and India as major sources, resistance to XDR has now spread to multiple other regions.
Approximately 200 cases of these strains traveling internationally have been recorded since 1990, with spread documented in Southeast Asia, East and Southern Africa, and even higher-income nations like the United Kingdom, the United States, and Canada.
The fast spread of these strains indicates the problem is worldwide and reveals that all countries may be at risk from drug-resistant typhoid. The movement of these resistant strains internationally brings attention to an important public health problem, dailygalaxy.com reported.
Furthermore, “the recent emergence of XDR and azithromycin-resistant S Typhi creates greater urgency for rapidly expanding prevention measures,” as the authors stated.
The global reach of these resistant strains supports the possibility that, without action, many more countries would soon have to manage hard-to-control outbreaks.
With the rise in treatment resistance, the number of good treatments for typhoid fever continues to decrease.